Pregnancy involves significant hormonal and physiological changes likely to cause many imbalances. If, during this period, your fingers (thumb, index finger and middle finger) seem numb or tingling, it may be carpal tunnel syndrome . EPITACT® tells you more about this condition often associated with pregnancy and about the solutions to relieve pain.
Carpal tunnel syndrome: what is it?
Carpal tunnel syndrome (CTS) corresponds to the compression of the median nerve inside the carpal tunnel , located within the wrist. Its core symptoms are tingling, pain and numbness in the first three fingers and half of the ring finger. Several factors aid the development of these pains. Some of them are intrinsic and increase the volume inside the carpal tunnel , others are extrinsic and modify its contour(1). Mainly occurring at night, the symptoms of this condition contribute to the deterioration of sleep quality(2).
Does pregnancy favour carpal tunnel syndrome ?
Pregnancy is characterised by morphological and physiological changes in women body. These changes can lead to dysfunctions. CTS is one of the conditions likely to occur during the 9 months of pregnancy. During the third trimester, there is a higher number of cases(3, 4) but CTS can appear over the previous months(3, 5). The prevalence reaches between 3 and 6% of the general population(6) and 7 to 62% of pregnant women(7). Therefore, these figures prove that pregnancy is a risk factor of carpal tunnel syndrome (3).
Why is CTS favoured by pregnancy?
During this period, some factors are added to the usual ones and increase susceptibility to CTS. Hormonal changes and fluid retention play an important role in the onset of this condition(4, 8). Fluid retention, caused by decrease efficiency of venous return, manifests with a local oedema that reduces the space available in the carpal tunnel and then increases pressure on the median nerve. Weight gain associated with pregnancy also increases the risk of having carpal tunnel syndrome (8).
What solutions to relieve pain in the fingers during pregnancy?
To palliate the symptoms of carpal tunnel syndrome , many solutions exist. During pregnancy and according to the symptoms, it is preferable to opt for conservative treatments rather than surgical treatments.
Among conservative treatments, braces that place the wrist in a neutral position or at a 20° angle are generally sufficient(9). If necessary, they can be combined with local steroid injections. Drugs can also be prescribed.
EPITACT® has created two braces for day or night to help you relieve pain and symptoms related to carpal tunnel syndrome , especially during pregnancy. The CARP'ACTIV™ brace* allows to correct movements by yourself and to keep full function of the hand. The CARP'IMMO™ brace* immobilises the hand at night to rest the joint and relieve pain for more peaceful nights.
Recommended as a last resort, surgery is performed under local anaesthesia in early pregnancy or after delivery. Symptoms usually disappear after delivery but in some cases, they can persist from the 6th month of pregnancy for up to 3 years after.
*These products are class I medical devices that bear the CE marking under this regulation. Carefully read the instructions before use. Manufacturer: Millet Innovation. 11/2021
For more details about this general and simplified approach, here are further sources:
(1)Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal Tunnel Syndrome: A Review of Literature. Cureus . 19 March 2020
(2)Aboonq MS. Pathophysiology of carpal tunnel syndrome . Neurosciences (Riyadh). janv 2015;20(1):4 9.
(3)Oliveira GAD de, Bernardes JM, Santos E de S, Dias A. Carpal tunnel syndrome during the third trimester of pregnancy: prevalence and risk factors. Arch Gynecol Obstet. sept 2019;300(3):623 31.
(4)Pazzaglia C, Caliandro P, Aprile I, Mondelli M, Foschini M, Tonali PA, et al. Multicenter study on carpal tunnel syndrome and pregnancy incidence and natural course. Acta Neurochir Suppl. 2005;92:35 9.
(5)Meems M, Truijens S, Spek V, Visser L, Pop V. Prevalence, course and determinants of carpal tunnel syndrome symptoms during pregnancy: a prospective study. BJOG: Int J Obstet Gy. juill 2015;122(8):1112 8.
(6)Eisenbud L, Ejadi S, Mar N. Development of carpal tunnel syndrome in association with checkpoint inhibitors. J Oncol Pharm Pract. avr 2021;27(3):764‑5.
(7)Padua L, Di Pasquale A, Pazzaglia C, Liotta GA, Librante A, Mondelli M. Systematic review of pregnancy-related carpal tunnel syndrome . Muscle Nerve. nov 2010;42(5):697 702.
(8)Wright C, Smith B, Wright S, Weiner M, Wright K, Rubin D. Who develops carpal tunnel syndrome during pregnancy: An analysis of obesity, gestational weight gain, and parity. Obstet Med. juin 2014;7(2):90 4.
(9)Weimer LH. Neuromuscular disorders in pregnancy. In: Handbook of Clinical Neurology . Elsevier; 2020 . p. 201 18.